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Co-payments and the demand for pharmaceuticals: Evidence from Italy

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  • Fiorio, Carlo V.
  • Siciliani, Luigi

Abstract

This study exploits a natural experiment in Italy to estimate how the demand for pharmaceuticals responds to variations in co-payment levels. After a period where co-payments were set to zero by a national law, the decision over co-payments was devolved to the Italian regions. While some regions re-introduced the co-payment, others did not. Using a difference-in-difference approach on regional monthly data for years 2001 and 2003, we find that an increase in the co-payment by one Euro reduces the per capita number of prescriptions by 4% and per capita public pharmaceutical expenditure by 3.4%. We also find evidence that when in 2006 some regions reduced (but not removed) the co-payment, a reduction in the co-payment by one Euro increased the per capita number of prescriptions by 3.4%, and per capita public pharmaceutical expenditure by 4.9%.

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  • Fiorio, Carlo V. & Siciliani, Luigi, 2010. "Co-payments and the demand for pharmaceuticals: Evidence from Italy," Economic Modelling, Elsevier, vol. 27(4), pages 835-841, July.
    • Handle: RePEc:eee:ecmode:v:27:y:2010:i:4:p:835-841
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    Cited by:

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    2. L. G. González Ortiz & G. Masiero, 2013. "Disentangling spillover effects of antibiotic consumption: a spatial panel approach," Applied Economics, Taylor & Francis Journals, vol. 45(8), pages 1041-1054, March.
    3. Sabine Vogler, 2019. "Fair prices for medicines? Exploring competent authorities’ and public payers’ preferences on pharmaceutical policies," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 46(3), pages 443-469, August.
    4. Patrizio Armeni & Claudio Jommi & Monica Otto, 2016. "The simultaneous effects of pharmaceutical policies from payers’ and patients’ perspectives: Italy as a case study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(8), pages 963-977, November.
    5. M. Filippini & G. Masiero, 2012. "An empirical analysis of habit and addiction to antibiotics," Empirical Economics, Springer, vol. 42(2), pages 471-486, April.
    6. Ponzo, Michela & Scoppa, Vincenzo, 2021. "Does demand for health services depend on cost-sharing? Evidence from Italy," Economic Modelling, Elsevier, vol. 103(C).
    7. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    8. Livio Garattini & Katelijne Vooren, 2013. "Could co-payments on drugs help to make EU health care systems less open to political influence?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 709-713, October.

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